QPR. Ask A Question, Save A Life

Transcription

1 QPR Ask A Question, Save A Life

2 Bridge Story Completed in foot drop Architectural marvel Over 1500 documented suicides 2-3 people per week stopped from jumping Which bridge is it?

3 Golden Gate Bridge

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5 Bridge Story Dr. David Rosen, psychiatrist, interviewed 9 people who jumped from the Golden Gate and Bay Bridges but survived: What was immediately apparent was that none of them had truly wanted to die. They had wanted their inner pain to stop; they wanted some measure of relief; and this was the only answer they could find. They were in spiritual agony, and they sought a physical solution. From The Urge to End it All by Scott Anderson, NY Times, 7/6/08

6 Suicide prevention is not so much the stopping of a self-inflicted death as it is the restoration of hope in the hopeless before the fatal planning begins Unknown Author

7 QPR Question, Persuade, Refer

8 National Statistics on Suicide Estimated that 1,100 college students die by suicide each year--around 3 completed suicides per day. Suicide is the second leading cause of death for college students LGBTQQ students were 25% more likely to consider suicide (Iowa College Climate Survey, 2011)

9 Statistics-2011 Survey-National Results for Undergraduates.80 % attempted in the last year 75% of those students who attempted were ambivalent 55% were using alcohol or drugs during the attempt

10 Statistics Students who binge drink alone are 4 times more likely to have attempted suicide (Gonzalez, 2012) Male students are more than twice as likely to die by suicide as compared to female students (Drum, et al, 2009) 80% of students who die by suicide did not go to the University Counseling Center we must be proactive (Kisch, Leino, & Silverman, 2005)

11 Statistics 95% of college students who completed suicide were suffering from a major mental illness (eg. Major Depressive Disorder, Bipolar Disorder, Substance Abuse Disorder) (AFSP, 2002)

12 Those left behind

13 Surviving a Suicide Loss A loss survivor is someone who experiences a major life disruption in the aftermath of a completed suicide On average, 25 loss survivors are directly affected by each suicide If there is a suicide every 12.8 minutes, there are at least 25 new loss survivors every 12.8 minutes More than one million Americans were loss survivors in 2013 Between 1989 and 2013, there were more than 20 million loss survivors which is 1 in 15 Americans Suicide risk is greater in survivors (e.g. 4-fold increase in children when a parent dies by suicide)

14 Personal Experience Has anyone ever had to deal with suicide before? Many feelings come up for those left behind

15 Surviving a Suicide Loss Shock-numb, disoriented Depression symptoms Anger-at them and self Relief-due to severe mental illness Guilt- If only I had

16 Surviving a Suicide Loss-Quotes I can live with it but not accept it I love them and hate them He took my life too You don t get over it, you get through it The last paragraph doesn t tell the whole story You don t have to decide today how you are going to feel the rest of your life

17 Surviving a Suicide Loss-Support American Foundation of Suicide Prevention-- A) Local support groups B) Resources and advice C) International Survivors of Suicide Day-November D) Out of the Darkness-Community Walk December Upland Memorial Park

18 QPR QPR is not intended to be a form of counseling or treatment. QPR is intended to offer hope through positive action.

19 QPR Suicide Myths and Facts Myth No one can stop a suicide, it is inevitable. Fact If people in a crisis get the help they need, they will probably never be suicidal again. Myth Confronting a person about suicide will only make them angry and increase the risk of suicide. Fact Asking someone directly about suicidal intent lowers anxiety, opens up communication and lowers the risk of an impulsive act. Myth Only experts can prevent suicide. Fact Suicide prevention is everybody s business, and anyone can help prevent the tragedy of suicide

20 QPR Myths And Facts About Suicide Myth Suicidal people keep their plans to themselves. Fact Most suicidal people communicate their intent sometime during the week preceding their attempt. Myth Those who talk about suicide don t do it. Fact People who talk about suicide may try, or even complete, an act of self-destruction. Myth Once a person decides to complete suicide, there is nothing anyone can do to stop them. Fact Suicide is the most preventable kind of death, and almost any positive action may save a life. How can I help? Ask the Question...

21 QPR Suicide Clues And Warning Signs The more clues and signs observed, the greater the risk. Take all signs seriously.

22 QPR Direct Verbal Clues: I ve decided to kill myself. I wish I were dead. I m going to commit suicide. I m going to end it all. If (such and such) doesn t happen, I ll kill myself.

23 Indirect Verbal Clues I m tired of life, I just can t go on. My family would be better off without me. Who cares if I m dead anyway. I just want out. I won t be around much longer. Pretty soon you won t have to worry about me.

24 QPR Behavioral Clues: Any previous suicide attempt Acquiring a gun or stockpiling pills Co-occurring depression, moodiness, hopelessness Putting personal affairs in order Giving away prized possessions Sudden interest or disinterest in religion Drug or alcohol abuse, or relapse after a period of recovery Unexplained anger, aggression and irritability

25 Focus on Firearms Firearms are the leading suicide method in the U.S. Gun owners and their families are at about 3 times higher risk of suicide than non-gun owners. This isn t because they re more suicidal. Gun owners are NO more likely to be mentally ill, to think about suicide, or to attempt suicide. They re simply more likely to die in a suicide attempt. Sources: - Miller M, Injury Prevention 2009 Findings also in ICARIS-2 survey - Betz M, Suicide Life Threat Behavior, Miller M, Injury Prevention, Ilgen M, Psychiatr Serv, Sorenson & Vittes, Eval Rev, 2008.

26 QPR Situational Clues: Being suspended from school A recent unwanted move Loss of any major relationship Death of a parent, sibling, or best friend, especially if by suicide Diagnosis of a serious or terminal illness Sudden unexpected loss of freedom/fear of punishment Anticipated loss of financial security Loss of a cherished professor or counselor Fear of becoming a burden to others Lack of social support

27 Common Warning Signs: Is Path Warm? I Ideation S Substance Abuse P Purposelessness A Anxiety T Trapped H Hopelessness W Withdrawal A Anger R Recklessness M Mood change

28 Symptoms of Clinical Depression Irritable or depressed mood daily for two weeks Change in sleeping and eating patterns Loss of interest or pleasure in usual activities Decrease in sexual drive Fatigue or loss of energy Diminished ability to think or concentrate Thoughts of death or suicide, or wishing to be dead

29 Fundamental Risk Factors The Many Paths to Suicide Proximal Risk Factors Triggers or Final Straws Cause of Death Biological Crisis in Relation Poison Genetic Load Sex Race Loss of Freedom Gun Personal/Psychological Child Abuse Environmental Season of year Loss of Parent Geography Culture Shock/ Shift Urban vs. Rural Values Religion Beliefs Age Drugs or Alcohol Model for Suicide Fired/ Expelled Illness Major Loss Increasing Hopelessness Contemplation of Suicide as Solution WALL OF RESISTANCE Hanging Autocide Jumping All Causes are real. Hopelessness is the common pathway. Break the chain anywhere = prevention.??

30 Wall of Resistance to Suicide Counselor or therapist Duty to others Others? Good health Medication Compliance Fear Job Security or Job Skills Difficult Access to means Pet(s) Best Friend(s) Religious Prohibition Responsibility for children A sense of HOPE Calm Environment Safety Agreement -- Sobriety -- Protective Factors Support of significant other(s) Positive Self-esteem AA or NA Sponsor Treatment Availability

31 Protective Factors-College Students Supportive family Ability to regulate emotions Problem-solving and conflict-resolution skills Coping skills Positive view of future Cultural or religious views discourage suicide Access to mental health care Willing to ask for help

32 Suicidal Crisis Episode 7 Risk is Imminent Risk Level Initial Hazard is Encountered 2 1 Stable Crisis Begins Crisis Peaks Crisis Diminishes Stable Years Days Hours Days Years Approximately 3 weeks

33 QPR Tips for Asking the Suicide Question If in doubt, don t wait, ask the question If the person is reluctant, be persistent Talk to the person alone in a private setting Allow the person to talk freely Give yourself plenty of time Have your resources handy; QPR Card, phone numbers, counselor s name, counseling crisis pager number Remember: How you ask the question is less important than that you ask it

34 Q QUESTION Less Direct Approach: Have you been unhappy lately? Have you been very unhappy lately? Have you been so very unhappy lately that you ve been thinking about ending your life? Do you ever wish you could go to sleep and never wake up?

35 Q QUESTION Direct Approach: You know, when people are as upset as you seem to be, they sometimes wish they were dead. I m wondering if you re feeling that way, too? You look pretty miserable, I wonder if you re thinking about suicide? Are you thinking about killing yourself? NOTE: If you cannot ask the question, find someone who can.

36 WAYS NOT TO ASK THE QUESTION You re not thinking about suicide are you? OR You re just kidding about killing yourself, right? Asking in this way encourages a negative response from the person you are talking with. It may also imply that you are frightened by the intensity of their feelings. Similarly, be aware of your own non-verbal clues.

37 P PERSUADE HOW TO PERSUADE SOMEONE TO STAY ALIVE Listen to the problem and give them your full attention Remember, suicide is not the problem, only the solution to a perceived unsolvable problem Do not rush to judgment Offer hope in any form

38 P PERSUADE Then Ask: Will you go with me to get help? Will you let me help you get help? Will you promise me not to kill yourself until we ve found some help? YOUR WILLINGNESS TO LISTEN AND TO HELP CAN REKINDLE HOPE AND MAKE ALL THE DIFFERENCE.

39 R REFER Suicidal people often believe they cannot be helped, so you may have to do more. The best referral involves taking the person directly to someone who can help. The next best referral is getting a commitment from them to accept help, then making the arrangements to get that help.

40 Suicide Intervention Notice warning signs Ask Are you thinking about suicide? Tell them you are going to get help Call 911 or CHC Campus Police

41 Referral Numbers National Suicide Hotline Redlands Community Hospital (909) Loma Linda Behavioral Medicine Center (909)

42 Other Resources U-Lifeline- Trevor Project U-TREVOR or It Gets Better Project- To Write Love on Her Armswww.twloha.com

43 REMEMBER Since almost all efforts to persuade someone to live instead of attempt suicide will be met with agreement and relief, don t hesitate to get involved or take the lead.

44 For Effective QPR Say: I want you to live, or I m on your side...we ll get through this. Get Others Involved. Ask the person who else might help: Another C.A.? C.D.? Roommate? Family? Friends? Chaplain? Staff? Coach? Professor? Doctor? Counselor? Psychiatrist? Administrator?

45 For Effective QPR Follow up with a visit or a phone call to let the person know you care about what happens to them. Caring may save a life.

46 ANY QUESTIONS?

47 GEESE STORY